Long-term care facilities have some unique characteristics that require special attention above and beyond standard hospital-grade infection control protocols. We can consider the appropriate prevention and control actions in the context of common infection transmission routes:

Direct contact — Physical contact with an infected person.

Indirect contact — From a contaminated object or person (uniforms, gowns, and other clothing; shared activity equipment is a common source).

Droplet — From an infected person’s respiratory tract during coughing, sneezing or talking. Zone of risk can be up to six feet.

Airborne — Small particles remain suspended in air and can be inhaled by susceptible people.

Cover your mouth and nose with a tissue whenever you cough and promptly dispose of used tissues.

Perform hand hygiene after contact with respiratory secretions.

Offer masks to coughing residents, staff, or visitors and encourage them to maintain approximately three feet (one meter) distance from others. If zone is six feet, wouldn’t that be a better recommendation?

Equipment and Devices

Each facility should have a strategy for dealing with single-use medical devices and equipment.

A central area should be allocated for cleaning, disinfecting and/or sterilizing equipment and devices for use.

Written policies and staff training on treatment of devices and equipment are essential.

Cleaning and disinfecting processes should be consistently monitored to ensure quality and compliance.

Employee Personal Hygiene

Daily showers or baths.

Clean, neatly trimmed, unpolished nails, no false nails.

Clean uniform every day. Change when leaving the facility.

Signage In the interest of preventing the spread of infection, it’s hard to post too many reminders. Respect for the resident’s privacy is an important concern as well. Signs should remind residents, visitors, and staff about:

hand hygiene,

maintaining safe distances,

disinfecting care equipment or dedicating it to a single resident

using PPE, and

checking with the nursing station before entering the room

Environmental Services

Cleaning and disinfecting should be continuously performed.

Clear standards for cleaning and disinfecting should be defined and it should be similarly clear who is accountable for compliance.

Continuing education of cleaning staff is essential.

Cleaning practices should be routinely monitored and audited.

Pets and Service Animals

Service animals, pets, pet therapy animals can harbor and pass germs or parasites to humans, or spread animal diseases to humans.

Follow all the same precautions after contact with pets as after contact with humans.